Background: While health systems are striving for patient-centered care, they have little evidence to guide them on how to engage patients in their care, or how this may affect patient experiences and outcomes.
Objective: To explore which specific patient-centered aspects of care were best associated with depression improvement and care satisfaction.
Methods: Design: observational.
Setting: 83 primary care clinics across Minnesota.
Subjects: Primary care patients with new prescriptions for antidepressants for depression were recruited from 2007 to 2009.
Outcome measures: Patients completed phone surveys regarding demographics and self-rated health status and depression severity at baseline and 6 months. Patient centeredness was assessed via a modified version of the Patient Assessment of Chronic Illness Care. Differences in rates of remission and satisfaction between positive and negative responses for each care process were evaluated using chi-square tests.
Results: At 6 months, 37% of 792 patients ages 18-88 achieved depression remission, and 79% rated their care as good-to-excellent. Soliciting patient preferences for care and questions or concerns, providing treatment plans, utilizing depression scales and asking about suicide risk were patient-centered measures that were positively associated with depression remission in the unadjusted model; these associations were mildly weakened after adjustment for depression severity and health status. Nearly all measures of patient centeredness were positively associated with care ratings.
Conclusion: The patient centeredness of care influences how patients experience and rate their care. This study identified specific actions providers can take to improve patient satisfaction and depression outcomes.
Keywords: Anti-depressive agents; depression; patient care management.; patient satisfaction; patient-centered care; primary health care.
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